Description
In this presentation, Mehdi Tofighi discusses a surgical technique called Transfocal Osteotomy for treating shear non-union of the tibia. He begins by outlining the high occurrence of oblique fracture patterns in tibial fractures and highlights the complications of delayed and non-union due to biological shear forces. Conventional fixation methods such as locking plates and intramedullary nails are acknowledged, but Tofighi emphasizes their limitations in controlling shear forces, particularly in oblique fractures.
The speaker introduces the concept of compression forces applied across a transverse fracture, utilizing a circular frame in the Transfocal Osteotomy approach. He shares cases treated from 2010 to 2018, detailing patient demographics, previous treatments, and the timing of transfocal osteotomy following failed interventions. Tofighi presents specific case studies, illustrating the successful healing of non-union fractures through this method, with a notable outcome of 9 out of 10 patients achieving full union without additional surgeries.
Key points include the importance of minimal soft tissue stripping, the use of the De Bastiane osteotomy technique, and the application of compression all of which contribute to successful healing in complex cases. Tofighi concludes by noting the advantages of this technique in cases where standard treatments fail due to compromised soft tissue conditions.